Defence Health Limited extras health insurance

Compare tailored extras cover for members of the ADF from Defence Health.

Defence Health Limited has spent decades serving the Australian Defence Force, defence industry and their extended families by offering high quality, cost-effective healthcare.

You are eligible to join this health fund if you:

Are a currently serving ADF member, or reservist who trains or serves 20 or more days a year.

Have previously served in the ADF

Currently work, or have previously worked in the Department of Defence and other related departments

Have worked for a defence supplier, or a company contracted by the Department of Defence, where you were involved in the supply of defence goods or services

You can also join if you’re part of the extended family. This includes partners, children, siblings, former spouses or partners, or grandchildren of any of the above.

finder.com.au does not currently have access to this health insurance brand. You may wish to compare options available on the health insurance homepage.

What kind of extras cover is available?

The three extras health plans are Premier Extras, Value Extras and Essentials Extras.

Essentials

Value

Premier

Ambulance treatment

Unlimited

Unlimited

Unlimited

Preventative dental

$500 combined dental limit

Unlimited

Unlimited

General dental

$500 combined dental limit

Unlimited

Unlimited

Major dental

Surgical extractions only

$900

$1,100

Orthodontics

no

$800

$1,000

Optical

$170

$255

$300

Alternative therapies

$200

$300

$400

Medical aids and devices

no

$1,000

$1,500

School accidents

no

$600

$800

Laser eye surgery

no

no

$1,500, claimable once every 2 years

Health and wellbeing

no

$100

$180

Flexi-limits cover

$450

$1,100

$1,500

What’s covered by flexi-limits?

This lets you get more out of your cover by claiming a wide range of procedures against the same generous limits.

Essential

Value

Premier

Total limit

$450

$1,100

$1,500

Initial consultation reimbursement

Set amount

Set amount

Unlimited, 100%

Physiotherapy and hydrotherapy

yes

yes

yes

Chiropractic/osteopathy

yes

yes

yes

Antenatal and postnatal

no

yes

yes

Pharmacy and vaccinations

no

yes

yes

Travel vaccinations

yes

yes

yes

Exercise physiology

yes

yes

yes

Psychology

no

yes

yes

Podiatry/chiropody

no

yes

yes

Occupational therapy

no

yes

yes

Speech therapy

no

yes

yes

Eye therapy

no

yes

yes

Dietician

no

yes

yes

Audiology

no

yes

yes

Picking a plan

Essentials: This affordable plan contains some of the most popular and useful extras, while still letting you claim money back for travel vaccinations and other practical but less commonly-used benefits. This cost-effective plan might be right for people who don’t have any particular health issues that might need medical aids, or don’t have children and therefore don’t want the benefits of school accident cover.

Value: A balance of cost and cover from this plan means it might be a good choice for many people. It delivers wide-ranging cover and includes benefits that might prove invaluable if something happens. However, the lower limits mean it might not be suitable for people with chronic health issues, or who otherwise know they’ll be claiming a lot of benefits.

Premier: The high limits and expansive cover of this policy mean it might be the optimal choice for people who are getting older and entering the age of ongoing health issues, or simply want the utmost protection. With cover for laser eye surgery and 100% back on initial flexi-limits consultations there are a lot of ways to make use of this option.

Are there any additional benefits?

Recognition of already-served waiting periods: If you transfer to Defence Health from another fund where you had equivalent benefits, any waiting periods served under your previous cover will be honoured.

Flexi-limits cover: The unique Defence Health flexi-limits cover means you can make full use of treatments as needed instead of including cover without knowing whether you’ll ever need it.

School accident cover: Another uniquely useful benefit from Defence Health, this no-waiting-period benefit means you can claim gap expenses, up to the specified amounts, relating to school accidents your children might experience.

Laser eye surgery: Claimable every two years, this rare extra inclusion lets you make sure your eyes stay in top shape without needing to wear glasses or contact lenses.

Health and wellbeing: Only available when you also take out hospital cover, this benefit lets you claim expenses up to the annual limits for approved health tests and programs. This includes bowel screening, kidney checks, mole mapping, bone density tests, mammograms, specialist eye tests, quit smoking programs and nicotine replacement therapies.

Defence Health app: This app can make it easier to claim, and easier to make full use of your extras cover.

One free kids’ mouthguard per year. When custom-fitted by a dentist, and when you have a Value or Premier extras policy.

Additional dental and optical benefits: Defence Health gives members a range of advantages, such as guaranteed maximum costs for select dental procedures, free tinting and coatings on prescription eyewear from partnered providers and more.

Limitations, exclusions and waiting periods

You cannot make claims before the end of the waiting periods. These are:

The amount you can claim per service depends on your chosen level of cover, as well as the nature of the service. Instead of only giving a set percentage back, Defence Health generally reimburses you a flat amount per item, meaning you’re able to predict your expenses more easily, and can take advantage of your extras cover without any out-of-pocket expenses which you might inevitably have with other health funds.

However, certain services are not claimable under Defence Health extras policies:

Items that may be payable by another third party or compensation scheme

PBS pharmaceuticals

Treatments claimed through Medicare

Services carried out by unapproved or non-accredited providers

How to claim

There are a number of ways to claim. The easiest is generally to download and use the Defence Health app, as you can make claims this way wherever you are, and even if your provider doesn’t have the facilities to process an electronic payment card.

Similarly, you can sign in to your online Defence Health account in order to make claims after paying for treatments.

Alternatively, you can swipe your membership card on a terminal where available, to automatically make a claim against your extras cover, and simply pay any difference yourself.

Some items, such as medical aids, may require you to fill out and send in a claims form, with the appropriate sections filled in by your service provider or doctor.

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